Pancho - URB-OSC-02

Code: URB-OSC-02
Mercy ID: V-00777-21
Encounter Date: 09/29/2004
Last: Urbina
First: Oscar
DOB: 03/17/2002
County: Dekalb
Street: 504 Brookridge Ave
City: Doraville
State: GA

Zip

30340-

Home

(770) 446-8221

Family Status

Attached youth

COB

Mexico

Gender

Male Child

Housing

Not Homeless

Education Level

Child, not in school

Home Owner

No

Parents Information

	Name	DOB	COB
Mother	Arcedalia Velasquez	03/24/1980	Mexico
Father	N/A	N/A	Mexico
Step Parent	N/A	N/A	N/A

Driver: No
Relative: No
Stranger: No
Lives With: N/A
Name of School: N/A
Grade: N/A
Who Can't Pickup the Child
Authoritation Parent: No
Authoritation Child: No
DOY PERMISO: No
Limitado Educativo: No
Limitado Impresos: No
Limitado Caminar Latino: No

Intake: Y. Garcia
Data Entry: K. Aleman